Forests for people - WHO · OF FORESTS 2011 Forests for people Q u a r t e r l y . APRIL 2011 QNT83 Association des Anciens de l’OMS Page 2 The year 2011 has been declared by the

APRIL 2011 QNT83

Association des Anciens de l’OMS Page 1

from the Association of Former WHO Staff Tel :+4122 791 3103 and 3192

Office 4141, WHO, CH- 1211 Geneva, Switzerland E-mail: [email protected] Website: http://who.int/formerstaff/en/

Informed opinion and active co-operation on the par t of the public are of the utmost

importance in the improvement of the health of the peopl e (WHO, Basic Documents, 47th Edition, 2009)

INTERNATIONAL YEAR

OF FORESTS●2011

Forests for people

Q u a r t e r l y

APRIL 2011 QNT83

Association des Anciens de l’OMS Page 2

The year 2011 has been declared by the UN as the International Year of Forests. The goal is to raise awareness of the importance of forests for life.

The forest, a precious and diversified environment.

In view of the importance of deforestation in the world, the UN has declared

2011 as the International Year of Forests. On this occasion, awareness-

raising campaigns will be organized around this theme for the general public.

Forests provide us with wood, work, areas of nature, protection against natu-

ral dangers, drinking water and places for relaxation. The forest is linked to

CO2 and attenuates global warming. In addition, forests provide shelter for

many animal and plant species, some of which are rare.

300 million people live in forests. (www.un.org/forests/)

Logo of the International Year of forests on UNO

← building in New York

APRIL 2011 QNT83

Association of Former WHO Staff Page 3

CONTENTS Pages

Photos Forests 2

Editorial opposite

Message from President; Functions and responsibilities 4

Our health 5, 6

Health Insurance 7

News from WHO 8, 9

Point of view 10

A story from WWII 11

Recent events 12, 13 In memoriam 14, 15 Book review 16, 17 On the lighter side

Readers’ Corner, 18, 19, 20, 21

New members 22 Joining AFSM

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Editorial Team Editing & layout: David Cohen

Editorial Board : Yves Beigbeder, Sue Block Tyrrell, Maria Dweggah, Samy Kossovsky, Jean-Paul Menu, Dev Ray, Michel Thuriaux, Rosemary Villars.

Translation, articles: all the editorial board.

--------------------------------

We pay special tribute

to the Printing, Distribution,

and Mailing Services. --------------------------------

The opinions expressed in this magazine are those of the authors and not necessarily those of the Editorial Board. --------------------

Send your contributions to: David Cohen:

[email protected]

EDITORIAL

Following the elections, responsibilities have been distributed within the new Executive Committee (see page 4). The Joint Committee of the Headquarters and Regional Surveillance Committees which met in 2008, set up a Working Group to review a re-form of the Staff Health Insurance (governance, financing and long-term care). Our Committee, which is represented on this Working Group, has given its position on the pro-posals of the SHI Secretariat (see page 7).

---------------- Serious events – an earthquake followed by a tsunami then a nuclear catastrophe, whose conse-quences for the future remain unknown – have occurred in Japan: we cannot remain indifferent to this tragedy.

We are sure that our readers will want to par-ticipate personally in the international aid efforts to support Japan at this difficult time.

Our attention is also focused on the historic changes occurring in North Africa and the Middle East. We assure our former colleagues, their families and the people in these countries of our solidarity and we extend our heartfelt wishes for peace, justice and prosperity. DC

Important contacts:

AFSM: see on page 1

Health Insurance (SHI): + 41 (0)22 791 18 18; in case of

absence, please leave a message; someone will call back.

Or email to: [email protected]

Pensions: +41 (0) 22 928 88 00 ;

email : [email protected] for Geneva or [email protected] for New York

AFSM office manned on Tuesday and Wednesday

from 9.30 to 12.30.

Otherwise: please leave a message; someone will call back.

APRIL 2011 QNT83


Message from the President

ear Readers, Things are happening in our health insurance.

In this Quarterly News you will find an article on “Health insurance: what’s new?” (page 7) as well as a letter from Marjory Dam, with our comments, in the Reader’s cor-ner. Some of you have received from another source a petition signed by Marjory Dam, Carole Modis and Ken Langford.

The letter from Marjory follows her non re-election by the AFSM Executive Committee as the alternate representative on the Headquar-ters Staff Health Insurance Surveillance Com-mittee and her subsequent resignation from the Executive Committee, together with that of Carole Modis. You will find below the details of our representatives elected for the current biennium.

We regret the resignations of Marjory1 and

Carol. Although urged by the Committee to reconsider their decision, they confirmed it to the AFSM during their respective terms of office.

Even though the Committee disagrees with the facts expressed in Marjory’s letter, we do not wish to enter into a controversy which will be pointless and counterproductive for everyone. We reassure you of our full commitment to continue to work with the Administration and retirees to secure the best possible govern-ance of the SHI Fund. Our priority is and will remain focused on protecting your interests to the best of our ability and we will keep you in-formed objectively on the new developments.

For this reason and more than ever, dialogue between us is important. Please do not hesi-tate to give us your views.

With best wishes. Jean-Paul Menu, Président

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2010-2012 Committee: Functions and responsibilities President : Jean-Paul Menu

Vice-Presidents: Sue Block Tyrrell, Dev Ray Treasurer: Anne Yamada Assistant Treasurer: Bunty Muller Administrator a. i.: Roberto Masironi

-------------------------------------------- Func tions and re spon sibilities Responsibles

AAFI/AFICS President (ex officio), replaced by a member of the Bureau when unavailable Staff Health Insurance David Cohen ([email protected]), Ann van Hulle ([email protected])

Pensions Ann Van Hulle ([email protected]), Bunty Muller ([email protected])

Relations with Regions Ann Van Hulle ([email protected]), Rajindar Pal

Relations with former staff

Roberto Masironi ([email protected]), Yves Beigbeder ([email protected]), Roger Fontana

Quarterly News: Editor in chief, submission of articles, photos and obituaries

David Cohen ([email protected])

AFSM telephone for information : 00 41 22 791 3103/3192 or email [email protected]

D

}

BUREAU

1. Due to this resignation, Maria Dweggah was declared elected. We warmly welcome her.

APRIL 2011 QNT83


Our health

Ischaemic stroke1: a new treatment technique

A new technique to remove blood clots from the brain, designed in the University Hospital of Geneva (HUG), is improving the prognosis of ischaemic strokes.

trokes can occur in two forms: haemorrhagic, when an artery bursts (in 30% of

cases) and ischaemic, when an artery is blocked (in 70% of cases).

An ischaemic stroke is painless but destructive: the brain tissues are no longer irrigated, there is a lack of oxygen, and each minute, 12 million neurons die asphyxiated. With the classic treatment used until very recently, the death rate from ischaemic stroke, all ages included, reached about 50%.

At the end of 2008, Dr Vitor Mendes Pereira from the Geneva Cantonal Hospital, had the idea of using a stent 2 to remove the clot blocking the artery. The results have been spectacular. “With this technique, the clot is removed completely in about 92% of patients treated. It is the key to our success. When the

stent is used, the vessel is partially open and circulation is instantly restored.

The clot which is trapped by the stent is then removed together with the stent” explains Dr Mendes Perei-ra. This method, developed at the HUG, is used today in hospitals around the world.

More rapid treatment

About 800 patients with ischaemic stroke present each year at the HUG. Unfortunately, only 10% of them are able to benefit from treat-ment. For the rest, it is too late. They have been deprived of oxygen for too long and the lesions are irreversible.

In the case of an attack of ischaemic stroke, it is therefore imperative to act rapidly (read the box). With the classic methods (intravenous throm-bosis = disaggregation of the blood clot by injection of a product), you had to be operated on at maximum

within four and a half hours after the attack and the results were not effective for large clots.

More effective treat-ment

The effectiveness of the new method has almost doubled the length of time available for treatment. “We are getting good

results up to eight hours after a cerebral attack” emphasizes Dr Mendes Pereira. In addition, we have found a net improvement in the results. In fact, 64% of patients treated have regained complete autonomy after a stroke. This level was only between 25-35% of cases using the previous methods.

Multicentric international study

A multicentric international study started in 2010 to enlarge the scien-tific base of clinical data. Piloted by Dr Pereira, it is being carried out over two years in some twenty hos-pital centres in Europe, Canada and Australia.

David Cohen, based on an article by André Koller in the magazine

Pulsations of the Cantonal Hospital, January 2011

-------------------------------------------- 1 Also referred to as ischaemic cerebral vascular accident (CVA) 1 A mechanism like a spring, normally used to keep open a blood vessel. It is not a question of leaving the stent in place, it is only used to trap the blood clot and remove it. In fact, the insertion of a stent into a fragile vessel in the brain would be risky for those over 70 years of age. (The Lancet, Stents may double the risk of stroke or dying in older patients compared to surgery, September 09, 2010).

S

Ischaemic stroke has the dangerous particularity of being pain-less. Nine times out of ten, patients are hospitalized when the lesions are already irreversible. In order to act without delay, it is vital to recognize the symptoms, such as partial paralysis of the arm or the face, with difficulty in articulating even simple phrases. In such cases, call the emergency services imme-diately. Rapid care can save lives and avoid hemiplegia (para-lysis on one side).

Act FAST: Facial weakness – can the person smile? has their mouth or eye drooped? Arm weakness – can they raise both arms? Speech problems – can they speak normally and understand you? Time to call the emergency services .

1. Introduction of the stent using a catheter;

it goes through the clot 2. The catheter is removed and the stent is

used to trap the clot

3. The stent is removed with the clot.

APRIL 2011 QNT83


Our health (Contd)

A health problem which is real enough but makes ot her laugh…. But you say – you mean Daltonism ( colour blindness). What is the problem ?

n case you have forgotten (or never knew), when you drive a car anywhere in the world, 8% of the male drivers ahead of or behind you suffer from a visual perception disability and are there-fore likely to be a danger to you. That is about 32.6 million people in Western Europe, the USA

and Japan.

According to the WHO International Classification of Functioning, Disability and Health (ICF 2001) these people suffer from a colour vision deficiency which pre-vents them from distinguish-ing and matching colours (achromatopsia or dyschro-matopsia).

They are at a disadvantage in numerous areas of life. To start with, more than 150 pro-fessions are closed to them – pilots, drivers and mechanics in the Navy, the Air Force, the Army and the Merchant Navy; air controllers in civil aviation, drivers and mechanics of rail-ways and other public trans-port – (buses, trains, under-ground).

To these must be added pub-lic security professions: po-lice, customs officers, fire fighters.

Pharmacists, electricians and electronic engineers, profes-sions related to textiles, print-ing, painting, photography, lighting (theatre, cinema, tele-vision) as well as sorting foodstuffs are also problem-atic.

Games on line can present a problem for a daltonian be-cause the games often use shades of red and green. Daltonism may hinder chil-dren in their studies and affect their self esteem. At nursery or primary school other chil-dren laugh at them when they colour grass red or a tiled roof green.

When cooking, a daltonian may have difficulty in seeing whether meat is rare or lightly cooked, whether “green” to-matoes are ripe and whether a sauce is tomato or choco-late.

In fact this colour vision defi-ciency most often leads to confusion between red and green. Known as Daltonism since the 18th century – it takes its name from the Eng-lish physician who was af-fected (diagnosis established by Dr Thomas Young in its most common form – defi-ciency in red and green), the anomaly is hereditary.

Daltonians make up 8% of the male and 0.5% of the female population. For a woman to be daltonian, her two parents must carry an abnormal gene X. The woman may then bear the daltonian gene (without being aware of it) and transmit it to her descendants. In fact, the mutated gene is recessive and must be

present in 2 genes Xd/ Xd to appear.

As far as driving a car is con-cerned, the tricolour lights at crossroads can only be dis-tinguished by their position and their luminosity. Green and red rear lights of cars often make it difficult to de-termine whether a car is ap-proaching or retreating...

In Geneva a few years ago, the municipal authorities be-gan to renovate traffic lights. I accompanied one of the officials responsible and showed him the green lights which appeared orange to me and those which seemed blu-ish which now are the only ones in use. I am still inca-pable of understanding the colours of the morning weather charts or of respond-ing when a repairman asks me over the phone whether the small light on my televi-sion is green or red.

During my medical studies I carefully camouflaged my disability in order to obtain an average score in histology and pathology. I hid it even more carefully during the tests to obtain a driving licence 60 years ago.

Reader, do not fear: I no longer have a car and am driven around.

Dr J-J Guilbert

I

APRIL 2011 QNT83


Health Insurance: what’s new ?

The new AFSM Executive Committee recently elected its representatives to the Headquar-ters Staff Health Insurance (SHI) Surveillance Committee.

n line with the Statutes, the term of of-fice of the member (David Cohen) and the alternate member (Ann Van Hulle-

Colbert) is two years. Both David and Ann have had many years’ experience in health insurance matters: David, in his capacity as a doctor in the Joint Medical Service for some 20 years, used to give advice to SHI, and later he participated for several years in the Headquarters Staff Health Insurance Surveillance Committee, either as the AFSM member or the alternate member. Everyone knows Ann Van Hulle who is a newly elected member of the AFSM Execu-tive Committee. Ann was elected as the AFSM alternate member on the Surveil-lance Committee for the first time; she has extensive experience in health insurance matters having managed that area for many years while working at WHO.

We are grateful for the opportunity to serve the AFSM members who participate in the WHO Staff Health Insurance. It is a par-ticularly challenging task at this point in time as the SHI Headquarters Surveillance Committee (HSC) is currently reviewing proposals from the WHO Administration for a significant reform of the existing govern-ance structure of the SHI. The HSC has formed a Working Group which has been reviewing proposals as well as other as-pects of the SHI Fund, especially financial matters and long-term care. The SHI par-ticipants (active and retired staff) share a seat on this Working Group.

The AFSM Executive Committee (EC) has recently conveyed its views/ recommenda-tions on the governance reform proposal to the SHI Secretariat and to the Working Group1. In formulating its views, the

AFSM EC took into consideration the re-cent Audit Report on Staff Health Insur-ance which identified a number of weak-nesses in the current governance of SHI. The AFSM EC has recommended amend-ments to the proposed new governance structure in order to ensure that the rights of former staff are not compromised. Is-sues such as parity in representation on the new committees have been stressed by AFSM.

We are very conscious of the importance of adequate and appropriate insurance cov-erage for long-term care (LTC). There have been improvements in LTC benefits over the past decade but we feel that more is required. We shall be pursuing this mat-ter during the months to come.

All of these matters will be discussed at a Joint Meeting of SHI Surveillance Com-mittees and Staff Committees in October this year. Recommendations arising from that Joint Meeting will subsequently be submitted to the Director-General for her concurrence.

The cost of health care continues to in-crease in most countries. We have a role to play in working with the HQ Surveillance Committee to ensure the rational use of SHI resources as well as efficiency in SHI administration while defending the rights and expectations of retired staff. Lastly, we are aware that there have been delays in reimbursement of claims from time to time over the last couple of years. The SHI Secretariat has assured us that these delays have been overcome. We are monitoring the situation very carefully and will address the problem again with the SHI Secretariat should it recur.

Ann Van Hulle-Colbert, David Cohen

1. The President of the Staff Association at Headquart ers confirmed that the Headquarters Associa-tion agreed with the position of the AFSM Committee .

I

APRIL 2011 QNT83


News from WHO

UN Secretary-General Ban Ki-moon visits WHO

Mr Ban Ki-moon had meetings with the Director-General on Wednesday 26 January and took the opportunity to address the staff at the end of the afternoon. He expressed his pleasure in working with WHO, notably during the H1N1 pandemic and during the cholera outbreak in Haiti, and em-phasized the importance of WHO’s work in all the current eight UN strategic priority areas: • sustainable development – with the extra challenge of facing a global recession • climate change • empowerment of women • ensuring a safer and more secure world • advancing human rights • improving response to major humanitarian crises • disarmament and the non-proliferation of nuclear weapons • strengthening of UN reform. Mr Ban Ki-moon thanked the staff for their contributions and commitment, especially in facing the challenge of assuming an increased role whilst at the same time receiving less financial support. Mr Lahouari Belgharbi, President of the Staff Association spoke after the Secretary-General’s ad-dress, assuring him of the continuing commitment of the WHO staff. The last visit by Mr Ban Ki-moon to WHO was in 2009.

Sue Block Tyrrell --------------------------------------------

Executive Board Technical resolutions were passed on:

• the eradication of dracunculiasis; • cholera – mechanism for control and prevention; • malaria; • child injury prevention; • health workforce strengthening; • strengthening national health emergency and disaster management capacities and resilience

of health systems; • strengthening nursing and midwifery; • strengthening national policy dialogue to build more robust health policies, strategies and

plans; • sustainable health financing structures and universal coverage; and • WHO’s role in the follow-up to the high-level plenary meeting of the 65th session of the UN

General Assembly on the review of the Millennium Development Goals. Other technical matters discussed include:

• pandemic influenza preparedness – sharing of influenza viruses and access to vaccines and other benefits;

• implementation of the International Health Regulations; • public health, innovation and intellectual property – Consultative Expert Working Group on Re-

search and Development – Financing and Coordination; • health system strengthening; • global immunization vision and strategy; • draft WHO HIV/AIDS strategy 2011-2015; • substandard/spurious/falsely-labelled/falsified/counterfeit medical products; • smallpox eradication – destruction of variola virus stocks; • leprosy (Hansen disease);

APRIL 2011 QNT83


News from WHO (Contd)

• prevention and control of noncommunicable diseases; • infant and child nutrition implementation plan; and • the UN Decade for Action for Road Safety – draft action plan. Progress reports were provided on many other technical matters.

In addition, management, staffing, financial and programme and budget matters were discussed, notably the potential substantial gap between projected income and expenditure, and the future of financing for WHO. The report by the Director-General referred to this packed agenda and to the fact that the Organization is over-extended. Dr Chan stressed that WHO does not need to change its Constitution but needs to undergo some far-reaching reforms in line with its purpose and unique contribution. “The level of WHO engagement should not be governed by the size of a health problem. Instead, it should be governed by the extent to which WHO can have an impact on the problem. Others may be positioned to do a better job.” Measures have been and continue to be implemented to reduce overall costs, increase efficiency and limit further growth in staff numbers. Structural changes include the disestablishment of the HQ cluster for Partnerships, country focus and UN reform, the closure of the WHO offices at the World Bank and in Washington, D.C., the merging of departments at HQ and in regions, and the devolution of several regional centres back to the host gov-ernment. A more developed plan for the reform of WHO will be submitted by the Director-General to the World Health Assembly in May 2011.

With regard to the election of the Director-General, the Board acknowledged that the successful candidate can come from any WHO region but that candidates appointed so far had only come from three of the six regions. The Board agreed to establish a working group, open to all Member States, to examine the process of nomination and appointment of the Director-General, with a view to enhancing fairness, transparency and equity among the Member States of the six WHO regions in this process.

The Board documents can be found on the WHO web site – www.who.int Sue Block Tyrrell ----------------------------------------------------

Highlights of the main public health events over the past few months are:

• A new meningitis vaccine became available at the end of 2010, priced under US$0.50 per dose – it is hoped to rid the meningitis belt (stretching from Senegal in the west to Ethopia in the East) of the primary cause of epidemic me-ningitis. The development of the vaccine was coordinated by WHO and the Program for Appropriate Technology in Health known as PATH.

• In December, WHO endorsed a new, rapid test for tuberculosis. It provides an accurate diagnosis in about 100 minutes compared to current tests which can take up to three months to have results.

• In January, WHO announced a new test for diagnosing diabetes mellitus which does not require a patient to fast before a blood sample is taken. The disease affects 220 million people worldwide.

• Also in January, a Hollywood film crew visited headquarters to shoot a short sequence for the film Contagion, about a deadly disease and an international team of doctors recruited to deal with the outbreak.

• A newly published Global status report on alcohol and health analyses alcohol consumption in over 100 countries – the evidence allows countries to create policies to reduce the health impact of harmful alcohol drinking.

• A new vaccine has been launched to protect children against pneumococcal disease which causes life-threatening illnesses such as pneumonia, meningitis and sepsis.

• 8 March 2011 marked the 100th celebration of International Women’s Day, with a focus on women’s access to science and technology.

• In March trucks carrying WHO staff and medical supplies, funded by Italy and Norway, were sent to the Libyan Arab Republic. The material consisted of trauma kits, equipment and treatment for surgical patients for use in the health facilities in the eastern city of Benghazi. A shipment of six tons of medical supplies for 50 000 people over 3 months was sent to Tunisia, to cover treatment for people crossing the border.

• Also in March, in response to the nuclear power plant crisis in Japan, WHO has been working with international scientific and technical partners to evaluate data and provide advice on health risks and about food and water safety.

• World Health Day on 7 April focuses on antimicrobial resistance and highlights the importance of countries taking action today to protect the medicines of tomorrow.

• The World report on disability will be launched in June. Further information and documentation can be found on the WHO web site – www.who.int Sue Block Tyrrell

APRIL 2011 QNT83


Point of view

World Health Report 2010 on:”Financing for universal health coverage” Is there progress from “HEALTH FOR ALL” of 1978?

HO’s World Health Report (WHR) is clearly one of the most important publications on specific aspects of health progress globally. This is now the second time after 2000 that Primary Health Care is revisited in WHR: this time regarding important – mainly financial and economic – aspects to achieve an overall goal:

universal health coverage.

It is quite frightening to learn from the DG that”... 20–40 per cent of all health spending is currently wasted...” She tells us “...the report identifies con-tinued reliance on direct pay-ments…as by far the greatest obstacle to progress…”

We also learn that “any effec-tive strategy for health financ-ing needs to be home grown…”, that “health sys-tems are complex adaptive systems”…, and that”...no one in need of health care...should risk financial ruin...” (Not many years ago, WHO’s own SHI reimbursed costs of long-lasting chronic illness only regressively between 80 and 20 per cent over time, causing substantial economic hard-ships for some pensioners).

This year WHR addresses issues which concern all for-mer WHO members: finan- c-ing of increasing chronic dis-eases and ageing population, the current economic down-turn and rising health care costs.

Many of us were working for the Organization at the time of Alma Ata Health for All (the earlier version of Universal Health Coverage), and, at a time, when Primary Health Care was relatively simple and straight forward. Then, the appeal was one for global solidarity in health matters, an issue which for some visionar-ies like Halfdan Mahler,

seemed achievable. Thirty years later, we seem further away from global equity, and it looks like, solidarity is pro-gressively replaced by eco-nomic and financial ‘system solutions’. This erosion is at the centre of concern for a growing number of health professionals, like David Werner, member of the ‘Peo-ples Health Movement’, who states in a comment to WHR 2010:…..”The facts are in. WHO’s recommendations for far-reaching policy changes are clear, if politically tooth-less. As ever, the biggest ob-stacle is the short-sighted resistance of the rich and powerful to what they selfishly condemn as socialized medi-cine. What it comes down to is that the Free Market Sys-tem is incompatible with health for all – and in the long run with Health for Anyone”. ‘Alma Ata’ and ‘Health for All’ is mentioned only once in WHR 2010 in the first sentence of the Ex-ecutive Summary (p. ix), re-ferring to “….contributing to quality of life ….and to global peace and security”. This makes one wonder, whether this was all WHO has learned from PHC. In the section “Where are we now?” (p. x), we learn that …”more than half of the world’s popula-tion lacks any type of for-mal social protection …”(and therefore guaranteed access

to professional healthcare) and only “5 – 10% of people are covered in sub-Saharan Africa and southern Asia…”. “Closing the coverage gap for children under-five, particu-larly for routine immuniza-tions, would save more than 16 million lives….” It would be interesting to know, what the comparative figures were in the nineteen-eighties.

The report identifies three fundamental, interrelated problems, which restrict ‘Uni-versal Coverage’: 1. Availability of Resources 2. Overreliance on direct

payment at the time people need care, and

3. Inefficient and inequitable use of resources.

A variety of well-known sys-tem solutions are offered in the section “How do we fix this?”

However, basic political is-sues, putting the individual in the centre of decision-making are not addressed. In the section “A message of hope” (p. xxi), we learn that there is no “magic bullet”. “Hope” in this context means to conform to technocratic solutions and expectations of the various health systems as defined by current country experiences and analyses. Man is clearly no more in the centre of self-determination. That is the basic change in analysis, tone and style between 1978 and now.

What have we learned from the past experience? Joachim Kreysler

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APRIL 2011 QNT83


A story from the Second World War..

...involving Brian Edwards and Samy Kossovsky

When I arrived in WHO in April 1972, I soon had the opportunity to meet Brian Edwards who has regret-tably recently passed away. “I knew a Kossovsky in Saint-Denis” … “It was my father”, I replied. “Ah” added Brian, “you were the young lad (I was 14 years old in May 1944) to whom I threw tins of food over the wall in the courtyard of the barracks”.

Brian had been arrested on 5 De-cember 1940 by the French police on the orders of the Germans, as he was an English subject of Her Maj-esty the Queen in occupied France, along with all the British subjects found in the Paris region – men, women and children.

The same happened to my family: my father, mother, my two brothers (aged 3 and a half and two years), and I were taken away at 6 a.m. by the police to the main police station in our district of Paris. My father, who had immigrated to France at the end of the 1920s, declared himself born in Jerusalem, Palestine, which was at that time under the jurisdic-tion of the Crown, and he had been registered as such. He was there-fore considered as a British subject by the occupying forces and the same applied to his family. In the basement of the main police station of this Paris district, families were separated – the men on one side, with the women and children on the other. The whole empire was repre-sented – the English and citizens of the colonies – white, black, Indians, even gypsies. My youngest brother was severely mentally handicapped, due to an infectious disease shortly after his birth. A military German doctor, who was called in to evalu-ate the case, declared that this did not prevent in the slightest either the detention of the whole family or its displacement.

Completely ignorant of the fate re-served for the men, their families met up on a train at a platform of the Gare de l’Est (East Station of Paris), at about 8 a.m., guarded by armed German soldiers. They gave us nothing to eat or drink but allowed some of the French people who happened to be at the station to give us bread, water, pâté, sausages, whatever they could find, and to take messages for our close friends and relatives and to communicate with us.

Without any information we stayed at the platform until 8 p.m. that eve-ning. Then the train began to move eastwards to an unknown destina-tion. In the early hours we passed through Vesoul then finally stopped at Besançon where many families were interned in Fort Vauban which overlooks the city. Those families with members who were sick or had small children were transferred to Saint-Jacques Hospital in the part which had been transformed into a German military hospital – including the mother and children of the Kossovsky family.

During this time (as we learned much later), the men had been locked up in the Romainville fort in the suburbs of Paris. After two and a half months the Germans thought it useless to keep and feed these whole families who were obviously not a threat, so they sent the wives and children back home. The men, however, were in Drancy, in what was called the “sky-scraper”. When these buildings at Drancy were transformed into death chambers, especially for the Jews, the British prisoners were housed in the large Saint-Denis barracks, still in the Paris suburbs. It was called the “Lager (Camp) 111”. Each prisoner had to know his assigned number (my father was number 78/111).

Brian Edwards was the youngest of the prisoners. Had he been two or three months younger, he would have stayed with his mother and would have passed the time of the occupation on the outside, as was the case for me. We had the right to visit the prison-ers for half an hour on Thursday mornings in an extremely noisy visiting room. It was forbidden for any prisoner to give any message or object whatsoever to their visitors. The fashion at the time was golfing trousers – surreptitiously my father passed me packets of “John Players and sons” which came out of the parcels from the British Red Cross or the St John’s Order and I hid them in my trouser legs. As you can imagine, English cigarettes during the German occupation were a real treasure which allowed us to get what we needed to improve our meager rations.

While it was possible to hand over small packets of ten cigarettes, it was another story to get tins of food which would have been much wel-comed at the family table. Hence came the idea to throw the tins from a window on the third floor of the barracks over the wall on one side of the courtyard, into the little grassy alley which ran alongside. A meet-ing was set for the afternoon and when I appeared in the alley, Brian, young and sturdy, threw the tins of corned beef, golden syrup and other food which I hurriedly stashed into a bag and took home. We were able to repeat the operation on several occasions, but it became clear that the German sentries could notice us and so we considered it best to stop.

There are of course many more tales to tell, but that will be for an-other time.

Samy Kossovsky

APRIL 2011 QNT83


Facts and events in Geneva

Coffee mornings in Nyon (10-12 noon)

QNT82 gave information on the monthly coffee mornings for former UN staff at the Sunset res-taurant opposite Nyon station. Below is a pho-to of the group taken on 16 February where three AFSM members were present – Angela Blattler, Sue Block Tyrrell and Arie Groenen-dijk. Do come and join us when you can. The

next dates are Tuesday 19 April, Wednesday 18 May, Thursday 16 June, Tuesday 19 July and Wednesday 17 Au-gust. Sue Block Tyrrell

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Activities of Former Colleagues

Break a leg!

ot literally, no! This article is not about broken limbs but about that good luck wish prof-fered to all Thespians before appearing on stage.

Many of you who live in the Geneva area (and some colleagues fly over especially for per-formances) go to see the stage productions of the Geneva Amateur Operatic Society (GAOS) – web site www.gaos.ch and the Geneva English Drama Society (GEDS) - web site www.geds.ch.

In the programme, you will often see that former WHO staff members are directing the GAOS shows, notably Kate Booth, Janet Clevenstine and Sue Lloyd, and others are helping with the cho-reography, the costumes and millinery, or are in the orchestra, backstage or front of house, notably Rosemary Wakeling, Valerie Buxton, Susan Bergomi and Nina Mattock. Kate, assisted by Janet, directed the most recent production of Cinderella in December 2010, and both ladies can also be found on stage as well as backstage and are members of various choral groups. The same goes for Sue, Valerie and Susan who have been very active members of GAOS for the past 30+ years. Valerie and Sue actually shared an office in the Congo in the mid-1960s, almost 50 years ago! At one stage, I had my office in HQ next to Sue’s and often heard her singing or dancing around the office! Rosemary is still very active in giving tap dancing classes (and has trained some former world champions) and Nina plays the flute or sings in musical groups. Jim Akre, Helena Mbele-Mbong, Michael Gurney, Michel Thuriaux and Philip Jenkins also sing in the GAOS Choral Group, as did Asha Singh Williams until she left Switzerland a few months ago. The original conductor of the Group was Roger Eggleston. The Group always welcomes new members if you would like to join!

Former staff members Wendy Gray, Neil-Jon Morphy and Diane Simmance are active in GEDS, either on stage, backstage or directing.

I am sure there are many other former WHO staff involved in GAOS and GEDS either now or in the past and I apologize for not citing all their names. Any anecdotes from such colleagues will be warmly welcomed.

Many former staff are highly talented and pursue their passions. We look forward to hearing about your retirement activities …...

Sue Block Tyrrell

N

APRIL 2011 QNT83


Facts and events (Contd)

Volunteering to fill gaps in community development

At first glance, the 1% for Development Fund1 may seem superfluous: after all, why do WHO and other United Nations agencies exist? But the Fund was founded in Geneva in 1976 by staff of the United Nations system out of frus-tration at the failure of most countries to meet stated targets for support of the developing world. Fund members were to contribute 1% of their salaries to community-development pro-jects, most of them too small for the pro-grammes of large national and international development agencies. The Fund has now disbursed about 7 million Swiss francs to more than 700 projects in 75 countries, mostly in Africa, Asia and Latin America. Because the Fund is administered by its members as volunteers, costs are minimal and are covered by periodic sales of handi-crafts from funded projects and by one-time donations. Members’ contributions thus go en-tirely to projects, many for improved community access to education, health care, clean water and sanitation. Fund members evaluate proposals from com-munity members, nongovernmental organiza-tions or other Fund members, for projects that cost up to 20,000 Swiss francs each. Twice a

year, promising proposals are submitted to a general meeting of Fund members for discus-sion and approval. The Fund requires regular reports on the use of its grants; where possi-ble, additional information is obtained through visits by Fund members or others on working or vacation trips. Independent 1% Funds now exist in Rome (at the Food and Agriculture Organization), New York (at United Nations headquarters) and Vi-enna (at the International Atomic Energy Agency). Membership in the Geneva 1% Fund is now open to the entire community, and more than 20% of its members are retired. Through the Fund, its members – in active service or retired, inside or outside the United Nations system – exercise technical expertise and ex-perience, idealism leavened by practicality, and trans-cultural solidarity. The Fund warmly invites additional participa-tion, whether through full or partial membership or contributions of money – one-off or periodic – in any amount. The finances are fundamen-tal, but members active in administering the Fund know that in sharing those resources they gain a great deal in fellowship with each other and with the communities they assist.

Janet Clevenstine 2 1. http://www.onepercentfund.net or The 1% for Development Fund, c/o International Labour Office, Room 4-52, 4 Route des Moril-

lons, CH-1211 Genève 22 2. Coordinator of the 1% Fund’s project evaluation and follow-up team

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The European sky for spring/early summer 2011 At this time of year the skies are much less brilliant than those of winter and autumn. The Milky Way is hugging the hori-zon and there are fewer stars to be seen. Find your way by looking for the familiar Plough (Big Dipper) almost overhead. Below it, in mid sky, is Leo, the Lion, with its curve of stars that really does resemble the mane of the Lion. Follow the curved handle of the Plough towards the horizon and you come to the bright yellowish star Arcturus, and beyond that, the white star Spica, in Virgo.

Above and to the west of Spica is Saturn. Notice that Saturn, being a planet rather than a star, does not twinkle. Stars are point sources, so their light is easily distorted as it passes through our atmosphere, whereas the larger disc of a planet, though it still appears as a dot to the eye, is less strongly affected. Now is a good time to look at Saturn through any telescope you can get your hands on. A magnification of about 30 is all you need to show its famous rings.

In dark skies, look for a scatter of faint stars about midway between Arcturus and Leo. This is a large cluster of stars in the constellation of Coma Berenices, Berenices’ Hair. Binoculars show the Coma star cluster really well, though it is not as well known as other clusters such as the Pleiades.

If you want help with finding more constellations, go to the Society for Popular Astronomy website: http://www.popastro.com/youngstargazers/skyguide/.

Article kindly provided by the British Society for Popular Astronomy

We are still hoping to get information on what can be seen in the Southern Hemisphere sky …..

APRIL 2011 QNT83


In memoriam

Peter OZORIO, Founder and Editor of AFSM's Quarterly News, died from a heart attack in Palo Alto, California, on New Year's Eve 2010.

His career with WHO began in 1958 and he worked for 14 years at AMRO in Washington D.C. As Editor of the staff newspaper Voz, he kept attention fo-cused on WHO's murdered colleague

Viviana Miccuci, one of Argentina's desa-parecidos. In 1972 he moved to the Liaison Office with the UN in New York, where his ef-forts in WHO's programme for smallpox eradication won him membership of the Order of the Bifurcated Needle. In 1977 he moved with his family to WHO head-quarters in Geneva, a move he called "a welcoming and transforming moment" in his life.

As Information Officer in the Division of Public Information (INF), he supported technical programmes and advocated health messages through such themes as "Cancer Is a Third World Problem Too," and "Heart Diseases Are Developing in Developing Countries." He recommended 31 May as "World No-Tobacco Day," now observed annually, and helped to en-courage the cartoon character Lucky Luke to exchange his cigarette for a straw. He was also responsible for the News Page of WHO's illustrated maga-zine World Health.

Peter was always a champion of human rights, and it was an open secret that he engendered "Le Serpent enchaîné," the tongue-in-cheek periodical of WHO's Staff Association that exposed infringe-ments or bending of rules. On his retire-ment in 1989, he founded Quarterly News for the retired staff of WHO.

Initially with only eight pages, his 50th Jubilee issue in 2002 had 24 pages.

Rubrics such as "Lifestyles," "Anything but Retired," "The Grand Art of Grand parenting, " Tom Strasser's "Health Cor-ner," and sorne 170 letters from readers reflected the broad spectrum of AFSM life. He was also on the editorial staff of UN Special and, while it existed, of WHO's Dialogue.

Of dual British and U.S. nationality, Peter was born in 1928 to parents of Macao origin in international Shanghai, attended a British school there and joined the English-language China Press as a cub reporter. He worked in Tokyo, Seoul (with the UN Korean Re-construction Agency) and London and, after immigrating to Canada, in To-ronto. He received degrees in journal-ism and political science from George Washington University, Washington D.C.

In December he set aside some ap-prehension about his own health and, with his wife Mary Lou and daughter Claire, enjoyed a cruise from Florida through the Panama Canal to San Diego, California, to link up with son Edmund and family. But at Christmas he fell ill and died in Palo Alto. Besides Mary Lou, Claire and Edmund, he leaves his son T.J. (resident in Flor-ida) and four grand-daughters - Kim, Jessica, Katherine and Emily - "les girls" who featured on the Ozorio family Christmas cards. A large crowd of family and friends attended a Memorial Service for Peter held on January 31 at the Cen-tre Jean XXIII in Petit Saconnex, Geneva.

John Bland

The current QNT editorial committee fully supports this tribute to Peter and conveys its deep condlences to his family."

APRIL 2011 QNT83


In memoriam (Contd)

Vittorio Fattorusso passed away on January 4th 2011.

Dr Vittorio Fatto-russo was a former Director of the WHO Division of Prophylactic, Thera-Therapeutic and

Rehabilitative Technologies.

He was the editor of Vademecun clinique: du symptôme à l'or-

donnance, a household name among medical students and young physicians from the 1940s onwards.

Those, like me, who had the opportunity to work with him, will always remember him as a knowledgeable, kind boss, full of understand-ing and, above all, a wise advisor. He was al-ways polite and gentlemanly, rare qualities these days.

I for one feel a profound vacuum over the loss of this great man who was so fully dedi-

cated to the global efforts of WHO

and especially towards people he felt were in "greatest need".

Dr. Fatorusso came to WHO from the Direc-torship of CIOMS, bringing to the Organiza-tion powerful knowledge and experience that clearly contributed in leading the WHO to-wards accomplishing its aims and objectives in highly controversial and conflict ridden situations.

Universal access to the basic and most needed technologies for health were at the top of his concerns and interests. Towards that end, he created the Unit of Drug Policies and Manage-ment, as well as other ways and means of pro-moting the concept of Essential Drugs and Vaccines. Because of his many thoughtful contributions to public health and universal well being, he will be remembered by this generation and public health professionals. Fernando Antezana

--------------------------------------- Guy Carrin (Guido) passed away on 28 March 2011:Guido was a wonderful person with whom I had dealings over the years. As a health economist, he had a keen interest in health insurance and was very active in that area in assisting countries. He participated in many of our SHI special studies and he was a real pleasure to work with. It is sad news and he must have been relatively young. Ann Van Hulle-Colbert

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Other deaths Margo Hermansen 4 March 2011 Josef Kierski May 2011 M.K. Q. Hashmi

Erlinda Petersen, 21 February 2011 Kalyan Baghchi Joan (H.J.L) Robertson 25 March 2011

About Kathleen Duckworth Barker (see In memoriam QN T82,)

Allow me to add a postscript to Fred Beer's "In memoriam" for Kathleen Duckworth Barker. He mentions the publication in 1955 of A Cure for Serpents, her translation from the original Italian of the memoirs of the Duke of Pirajno, which were highly praised at the time by such literary bigwigs as Cyril Connolly, Doris Lessing and Harold Nicholson, When, on behalf of our Association, I tele-phoned to wish her a happy hundredth birthday, she told me that her translation had been reissued in 1985 as a paperback (by ELAND, 53 Eland Road, London SW 11 5JX) and, 18 years later, was still selling and bringing her in a welcome trickle of royalties.

I don't know whether, after another seven years, it is still in print, but in any case I can recommend it as an enthralling read, perhaps of particular interest to our members for what it tells us about colonial health care in what were not yet called the developing countries.

Of course, those who can read Italian might prefer the original, if they can get their hands on a copy. John Fraser (ex TRA)

APRIL 2011 QNT83


Book review

Les invisibles by Yasmine Motarjemi, illustrated by Susan Litsios

Illness due to contaminated food and drinking constitute a major public health problem. Food and water can become contaminated at any stage of the food chain, including during storage and preparation before consumption. What better audience for promoting food safety awareness and proper food preparation hygiene than children who are forming life-long food habits with potential impact on their health.

Les Invisibles is a delightful book that can be read with pleasure by older children, read aloud by parents to the younger ones, or used as teaching ma-

terial in schools or other educational settings.

Les Invisibles tells the story of Sara, a young girl who is home sick in bed. With the help of her cat Rostam, she puts on her detective hat and discovers the invisible world of microbes and the danger they can pose to good health. She tracks down the source of the microbial agent that has sickened her and several of her classmates at school.

Through the investigation she learns

about various microbial agents and the source of contamination of foods. Finally, altogether they learn the often very simple but important measures needed to take to protect themselves in the future.

The book’s author is Yasmine Mo-tarjemi, of Iranian origins and with Swedish and Swiss nationalities. She has a doctorate in food engi-neering from the University of Lund, Sweden. Many of us knew Yasmine during the years she was working for the WHO Food Safety Programme, in the area of the surveillance and prevention of food borne diseases. She is the author of several WHO books in food safety, including Foodborne diseases: a focus on health education (WHO 2000) pro-moting the education of children in food safety.

She was inspired to write this book by reading reports of thousands of cases of foodborne illnesses in vari-ous countries of the world and the challenge to explain food safety to

the public in an entertaining manner. Her objective is to explain in simple language the dangers of foodborne pathogens and major misconcep-tions in food safety.

The story is full of suspense and interest, beautifully illustrated with charming pictures by Susan Litsios, an American artist and book illustra-tor who has had many solo and international exhibitions of her art-work. Her colourful, imaginative pictures bring a wonderful story to life and impart an important public health message to children and adults alike.

I gave the book a test drive with my young granddaughter; she loved the affectionate long-haired Maine coon cat Rostam, exciting story, and the entertaining drawings of the mi-crobes and other wonderful illustra-tions. We went off to wash our hands thoroughly before lunch, vowing that all together we can defeat the misery caused by the foodborne illnesses.

Carole Modis

So far Les Invisibles is only available in French; to order a copy, go to the web site at:www.elstir-editions.ch ; for additional information, you can contact Yasmine at [email protected].

------------------------------------------ Lost lives , the pandemic violence against children, Academic Press Lund, Sweden, 2011.

In December 2008 (QNT 74) I drew attention to a very moving book by Einar Helander on the sub-ject of "Children and violence". Einar has come out again with another very disturbing document on the same subject

It is a scholarly textbook of 275 pages with over 800 bibliographic references. The 30 photos of victims are very painful and "Lost Lives" does not make pleasant leisure reading. However if you find the courage to read, for example, a chapter a week you may, like I was, be shocked to dis cover that "it is estimated that 50% of all now living persons were abused sexually, physically, and/ or emotionally before they were 18 years old" i.e. " global prevalence of victims estimated at 3,400 million ".

APRIL 2011 QNT83


Book review (Contd))

The book includes a "short history of child abuse and neglect" and confronts the reader with the evidence of the global prevalence of the pandemic. It describes the combined sexual, physical or emotional abuse of children. It depicts both cases of children abused in residential institutions and the abuse derived from parental care. It quotes the Secretary-General of the United Nations (2005) about the "declining credibility and professionalism of the Human Rights Commission" undermining international law. The author denounces the "Causes and contributors to violent behaviour and its prevention". He takes us back to the behaviour of "Neanderthal hunter-gatherers" and is not very reassuring when stating that "the 20th century had the largest level of “democides” seen during the last 400 years : 7.9% of the world population (262 million) were murdered by paranoid country rulers". Halfdan MAHLER asks in the Foreword "what is the future of a world where people find them-selves surrounded by oceans of contagious violence, immoral behaviour, lack of compassion, and unwillingless to change?»

On the lighter side

Communication in hospital...

Good morning, is that the reception? I would like to talk to someone concerning a patient in your hospital. I would like to know how he is, whether he is get-ting better or worse. What is the name of the patient? His name is Joe Bloggs and he is in room 302. Just a moment please, I will pass you the nurse. After a long wait: Good morning, this is Frances the nurse on duty – how can I help you? I would like to know how the patient Joe Bloggs is in room 302. Just a moment please, I will try to find the doctor on duty. After a long wait: This is Dr Smith, the doctor on duty – how can I help? Good morning doctor, I would like to know how Mr Joe Bloggs is getting on – he has been with you for the past three weeks in room 302. Just a moment, let me check on the patient’s file. After another long wait: Hmmm, here it is. He has eaten well today, his blood pressure and pulse are stable, he is re-sponding well to the prescribed drugs and if all continues to go well, we should be taking off the heart monitor tomorrow. If everything goes well for the next 48 hours, his doctor will agree to his discharge between now and the weekend. Aaaah ! This is good news, I am thrilled. Thank you. By the way you talk, I imagine that you are someone very close to him, surely a member of the family? No doctor, I am Joe Bloggs and I am calling you from room 302. Everyone comes and goes in my room and no-one tells me anything. I just wanted to know how I was getting on! Many thanks!

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Or elsewhere… even when you speak the same language … Between what I think and what I mean, What I believe I say and what I do say,

What you want to hear, What you do hear, what you understand,

There are ten possibilities that we may have difficulty in communicating. But let’s try anyway.

Bernard Werber

APRIL 2011 QNT83


Readers’ Corner

RED: We received an open letter from Marjory Dam which explains her decision to resign from the AFSM Executive Committee.

This letter contains numerous inaccuracies and errors. For example, it is stated that “The Committee refused to recognize the problems of SHI governance and strongly rejected key elements of the reform". On the contrary, the Committee certainly recognized the weaknesses in the current governance but some felt that those weaknesses could be ad-dressed by improving the current structure rather than by dismantling it. The let-ter illustrates, as you will see, Marjory’s disappointment in not having been re-elected as a representative to the Staff Health Insurance and therefore not being able to continue to sit on the working group set up to study the reform of the health insurance. In fact, the election was totally democratic: 4 candidates presented themselves for 2 seats: the representative and the alternate. One of the candidates withdrew before the voting, and the members of the Committee elected two representatives, but not Marjory Dam. This is unfortunate, but it is the democratic rule.

----------------------------------------

Here it is:

« I should like to thank all those who supported me in the October 2010 election of the AFSM Executive Committee. However, I have resigned from the Executive Committee effective 8 February 2011.

« My decision to resign is due to issues related to reform of governance of the WHO Staff Health Insurance. My position to support reform proposals presented by the WHO Ad-ministration conflicted with the views of the majority of the Executive Committee, who op-posed key elements of the reform. The Executive Committee, therefore, voted to remove me as one of the two representatives of retired staff members on the Headquarters Staff Health Insurance Surveillance Committee. In light of this vote of no confidence, I felt it would be impossible for me to continue as a member of the AFSM Executive Committee.

The Headquarters Staff Health Insurance Surveillance Committee established a Working Group to review the insurance plan and to make proposals concerning inter alia its gov-ernance, which had become dysfunctional. At a meeting of the Working Group in October 2010, the WHO Administration presented workable proposals to reform the governance mechanisms. The majority of the members of the Working Group (myself included) viewed the reform proposals as positive. When I reported back to the AFSM Executive Committee, the Committee refused to recognize the problems of SHI’s governance and strongly rejected key elements of the reform. Subsequently, they voted to remove me from my functions as a member of the Working Group. However, at the meeting of the Working Group held at end-February 2011, the majority of its members agreed to the pro-posals, with some modification of details, so I guess you could say, “I was right!”

Retiree representation through AFSM in health insurance matters is a practice, not a right. I believe these recent events call into question the competence of AFSM’s Executive Committee to continue to represent the interests of the retirees in health insurance mat-ters. The Administration’s reform proposals include a provision whereby retired staff members participating in the Insurance would elect their representatives, at large. I urge all retired staff members to express their support for this reform ».

Marjory Dam Former Director, Governing Bodies Retir ed in 2007

APRIL 2011 QNT83


Readers’ Corner (Contd)

"VWPs" or "VIPs”?

Mr Ashok V. Desai, Consultant Editor of Businessworld, in a recent article, gifted us with a new acronym “VWP” - very similar to and rhyming with the familiar one: “VIP”. This was in the context of the statement made by 14 influential people from different fields writing to Prime Minister Man-mohan Singh to take immediate effective steps to check the all-pervading corruption in the country. Mr Desai justified why he called these 14 people “worthy” and not “important” as they took ‘respectable roads to acquire their riches’.

Going back to the acronym “VIP”, probably it started by referring to visiting foreign dignitaries or persons with high status in the country’s hierarchy like the President and Prime Minister. However, soon many more people having access to power centres, right from Ministers to Members of Par-liament or Legislative Assemblies – even lower down the line to District Boards - embellished themselves with the honorific ‘VIP” with all the accompaniments that are expected to arrive with it automatically – a revolving red light on their car, a preferential treatment on air-lines/railway reservations, jumping the long queues at temples etc. etc. Soon, because there were too many “VIPs” to be handled, another letter “V” (for very) was added to this acronym to refer to those who really were at the top. Hence, there was a scramble among “VIPs” to get elevated to “VVIPs”. Recent events have shown that, over a period time, thanks to the in-discretions (both in political and personal lives) and greed on the part of high and mighty in power to acquire unlimited wealth, even “VVIP” has become a “tainted” term not inspiring confidence and regard which otherwise they would have got because of the positions held by them.

So Mr Desai is to be thanked for bringing freshness by coining the term “VWP”. While anyone could become a “VIP” by being assigned to an important position, the “VWP” will have to prove himself or herself worthy of this honorific. Whether the 14 influential persons who are the first recipients of this title will justify such an honour by their envisaged campaign for divesting the country of the bane of corruption? Or whether future generations of political big-wigs will aspire to be called “VWPs” and not “VVIPs”? Only time will tell!

Shiv K. Varma

Dear M. Menu, My beloved mother passed away on June 8, 2010. I continue to receive notices, communications addressed to my mother - this should be discontinued. The only exception to this should be the Quarterly News of AFSM to which I had renewed the subscription for my mother in July 2010. I have immensely enjoyed my association with the WHO family for over half a century - by proxy through my parents. My father joined WHO in 1956 and was posted to the Sudan (Sennar in S. Sudan and his last posting in Khartoum as the WHO Rep), Egypt at Alexandria and Baghdad where too he was the WHO Rep. until his retirement and return to India in 1970. I will cherish memories of all the travels, throughout the Mid East especially, meeting wonderful people and making innumerable friends, the many holidays and living with my parents at all of their postings except Sennar through my young school and college years and beyond. Life has been an explo-sion of the mind, a learning experience like no other. My love and bonding with that part of the world is abiding and now I watch with trepidation, anxiety and excitement the sudden, sweep-ing and rapid changes that are taking place - almost like a forest fire - in every country that they were posted in. Even the geography of the Sudan is to be redefined. With the rest of the world I pray for peace and prosperity for all. I cope with my mum's loss one day at a time and miss her immensely. As for my dad, he was truly wonderful and after all these years the vacuum remains - my guru and mentor. I wish the AFSM and all your endeavours the best of luck in the wonderful work you do in inform-ing, entertaining and keeping the WHO flock, past, present and future bonded. With regards,

Indrani Roychowdhury Chari Bangalore, India

APRIL 2011 QNT83



Response to the letter from Joan Bentley on health workers in the field for the

magazine of the Association of Former WHO Staff Members (AFSM) (see QNT81).

Ellen Rosskam, Ph.D., MPH, Interim Technical Officer, Global Health Workforce Alliance, World Health Organization

'Field worker' is a categorization that include a variety of cadres, such as community health workers, mid level providers, midwives, skilled birth attendants, traditional birth assistants, nurses, and doctors. Ms. Bentley asked whether health workers in the field still exist. They do. But also all too often they don't, particularly in remote and poor areas. The backdrop to this scenario is that worldwide there is an estimated shortage of 4.3 million midwives, nurses, and doctors, with the shortage most severe in 57 priority countries (WHO, 2006). We are in the year 2011 but still only some 40% of births in low-income countries are as-sisted by properly skilled birth attendants (Fauveau et al, 2008). Yet we know that teams of midwives and midwife assistants working in health care facilities could increase coverage of maternity care by up to an additional 40% by 2015 (Koblinsky et al, 2006). Policy mak-ers and development partners struggle to help find solutions to the unacceptably high rates of maternal and newborn mortality in many low and middle income countries. Unfortu-nately though, progress has been too slow for most of the 57 priority countries to meet Mil-lennium Development Goals 4 and 5.

There are success stories however, where some countries struggling with but addressing the problem of access to skilled birth attendance in particular are making good progress towards achieving Millennium Development Goals 4 and 5. By introducing innovations in midwifery workforce management, countries such as Sri Lanka, Bangladesh, and Nigeria have been able to claim such achievements. The achievements of these countries show that addressing challenges in the 57 countries suffering from the most acute shortage of midwives, nurses, and doctors, calls for innovative thinking and innovative approaches, most urgently to reduce maternal and newborn mortality and morbidity. Attracting and re-taining health workers in remote areas is a particular challenge in the face of this crisis shortage of health workers. Strategic decisions are needed to address recruitment, reten-tion, and the motivation of midwives. Difficult as it may be, a number of low income coun-tries have demonstrated that meeting these challenges can be done, can be managed, and can be financed in resource-scarce settings.

Recent groundbreaking global research on community health workers has provided us with a list of key messages critical to attracting and retaining health workers in the field. Key messages that have come from this research (Global Health Workforce Alliance, 2010) provide a roadmap of concrete actions needed to scale-up and keep health workers in the field. The key messages (included below) address 3 core issues: Planning, produc-tion, and deployment; Attraction and Retention; and Performance Management.

Common to all 3 of these areas is the need for government support and political will. In-deed, today we have the evidence showing that where there is political will, there is a way.

Key messages for integrating community health workers in national health workforce plans (Global Health Workforce Alliance, 2010)

APRIL 2011 QNT83



Planning, Production and Deployment

• Integrate Community Health Workers (CHWs) fully into national Human Resources for Health (HRH) plans and health systems, taking into account existing needs, expected social benefits, local values and preferences.

• Involve key HRH stakeholders in the decision-making process, including relevant government bodies, civil society, private-not-for-profit and health professional groups. • Ensure effective and robust monitoring and evaluation throughout the policy and

implementation process for the scale-up of CHWs.

• Ensure that any scale-up of the CHW cadre in national health systems and/or in non governmental initiatives makes adequate provision of the additional costs and resources required for supporting the cadre (including training, supervision, equipment and sup-plies, transport).

• Take into consideration the need for complementary strengthening of the existing health system to provide the enabling environment for implementation of CHW policies and planned interventions.

Attraction and Retention

• Prepare and engage the community from the start in planning, selecting, implementing, monitoring and supporting CHWs.

• Ensure a regular and sustainable remuneration stipend and, if possible, complement

it with other rewards, which may include financial and non-financial incentives.

• Ensure a positive practice environment, including regular and continuous supportive supervision, health and safety issues, CHW’s information and communication needs, a clean environment, a manageable workload, and the availability of drugs/supplies/equipment.

• Establish terms of reference for selection criteria, training duration, and scope of tasks that are clearly stated, publicized and respected by all stakeholders.

• Provide an ongoing continuing education framework for CHWs and, where possible, support opportunities for career advancement, considering the needs of the individual as well as the organization.

Performance Management

• Governments should take overall responsibility for the quality assurance of CHWs as part of their stewardship role, even if CHWs are trained and managed by civil society or private-not-for-profit groups.

• Performance management should be based on a minimum standardized set of skills that responds to community needs and appraisal of strategies, and is context-specific.

• The management and supervision of CHWs should be integrated with that of other health workers, using a team approach, and should be developmental, systematic, planned and budgeted for accordingly, in order to achieve the desired service delivery and health outcomes.

References

The World Health Report 2006 - Working together for health, World Health Organization, Geneva, 2006. Fauveau, V., Sherratt, D.R., and de Bernis, L., Human resources for maternal health: multi-purpose or specialists? Hu-man Resources for Health, 6:21doi:10.1186/1478-4491-6-21, 2008. Koblinsky, M. et al, The Lancet, Vol. 368, 2006. Global Experience of Community Health Workers for Delivery of Health Related Millennium Development Goals: Sys-tematic Review, Country Case Studies, and Recommendations for Integration into National Health Systems, Global

APRIL 2011 QNT83


Readers’ Corner (Contd) Health Workforce Alliance, Geneva, 2010 http://www.who.int/workforcealliance/knowledge/resources/chwreport/en/ Additional references Increasing Access to Health Workers in Remote and Rural Areas Through Improved Retention, Global Policy Recom-mendations, World Health Organization, Geneva, 2010. State of the World's Midwifery Report, UNFPA, June 2011 Mid level providers: http://www.who.int/workforcealliance/knowledge/resources/mlpreport2010/en/index.html

New members

We have pleasure in welcoming to the large AFSM family the fol-lowing new members and we congratulate them on their decision. New life members: Barbara FONTAINE ; Corinne EVERITT-PENHALE New annual members: Marc JABOULIN ; David BALDRY; Linda BALDRY

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The more we are, the stronger we are Dear Readers, In principle, you are all members of AFSM but many retirees, for one reason or another, have not joined the Association. Yet, the more we are, the more we can represent and better defend our common interests, espe-cially concerning health insurance. We kindly request you all, both annual and life members, to try to convince your friends and acquaintances to join AFSM. Below is the enrolment form which you can give to them. Many thanks in advance for your help.

--------------------------- I am not yet a member and I want to join: as a life member (CHF 250); as an annual member (CHF 25 per year)

Dues can be paid either in cash at the office or through a postal form (add 2 CHF for charges) for persons who live in

Switzerland, or by bank transfer to the AFSM account number (+ bank charge, if any):

IBAN: CH 4100279279-D310-2973-1 SWIFT: UBSWCHZH80A

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JOINING AFSM

Name ………………………….. First Name

Address:

Postal Code ……………………… City…………… Country ....................................................................................

Phone ………. Fax .............................. e-mail ……….

Date of Birth …………………… Nationality …………………………………………………………………

Date of separation from WHO ………………………………. Length of service with WHO

I should like to receive documentation in □ English □ French

Date .................................................................................................................... Signature